Project Summary: The long-term objective of this research is to provide a comprehensive framework for quantifying the longer-term impact of war and related violence on global disease burden, expressed as disability adjusted life years (DALYs) due to: (1) substance use disorders; and (2) illicit drug use, alcohol use and tobacco use as risk factors for other diseases and conditions. To accomplish this objective, a comprehensive global analysis of the impact of war and related violence (i.e., terrorism, one-sided violence) occurring during the years 1994-2000 worldwide on DALYs attributable to substance use disorders or substance use in 2002 will be conducted controlling for important economic factors (e.g. health expenditures, income inequality) and disease-specific risk factors. Analyses will be conducted for the total population and for subgroups of the population defined by sex and age. This research is relevant to the mission of the National Institutes of Health (NIH) to pursue fundamental knowledge about addictive behaviors and the application of that knowledge to extend healthy life and reduce the burden of illness and disability. This research also addresses the NIH's Fogarty International Center's mission to prevent catastrophe and ameliorate global health problems by meeting formidable challenges resulting from an increasing global burden of disease due to noncommunicable diseases and conditions. This research also speaks to the mission of the National Institute on Drug Abuse, that is, to lead the nation in bringing science to bear on substance use and addiction and its Division of Epidemiology, Services and Prevention Research whose charge is to promote national and international research that examines interactions between individuals and environments that contribute to the continuum of problems related to drug use. PUBLICH HEALTH RELEVANCE: Current debates regarding evidence-based medicine and evidence-based policy are just as relevant to humanitarian health. Quantification of the effects of war on substance use and substance use disorders could assist post-conflict peace building missions, national governments and non-governmental agencies in suggesting interventions to protect populations from these consequences of conflict and to assess priorities for post-conflict public health and mental health allocations to substance abuse prevention and intervention.